Patient Authorization Liaison

4 weeks ago

Englewood, Colorado, United States Rocky Mountain Cancer Centers Full time

Position Overview:


Rocky Mountain Cancer Centers, a leading provider of oncology services, is seeking a skilled Authorization Specialist to join our dedicated team.

At RMCC, we believe that caring for cancer patients is not just a profession; it is a profound commitment to making a difference in their lives.

Our team members come from diverse backgrounds, yet we are united by our shared values of empathy, dedication, and excellence in patient care.


Every role at RMCC contributes to our mission: to deliver exceptional care to our patients.

Whether you are a healthcare professional providing direct support or a coordinator ensuring seamless service delivery, your work will have a meaningful impact on our patients' journeys.

If you resonate with our mission, we invite you to explore this opportunity with us.

Key Responsibilities:

  • Evaluate, process, and verify the medical necessity for chemotherapy treatments, ensuring compliance with established protocols.
  • Act as a patient advocate, serving as a communication bridge between patients and insurance providers to address inquiries and mitigate reimbursement challenges.
Secure insurance authorizations and pre-certifications for chemotherapy services. Investigate alternative resources for non-covered treatments to minimize payment denials. Provide patients with a comprehensive list of community resources, including specialized programs and financial assistance options.

  • Collaborate with nursing and medical personnel to relay any insurance-specific requirements or limitations.
Offer timely updates to physicians and management regarding documentation discrepancies and payer-related issues concerning non-covered chemotherapy medications.

  • Prepare and submit requests for write-offs with the necessary documentation.
  • Handle insurance and patient correspondence, including follow-ups on denials.
Maintain organized records of reimbursement communications and filing systems. Review and process adjustment and refund requests. Assist in the evaluation of financial disclosures and negotiated agreements. Provide support for Patient Financial Counselors. Report any emerging issues or trends related to payers.

  • Stay informed about chemotherapy authorization requirements across various payers, as well as state and federal regulations.
Adhere to confidentiality laws and regulations concerning patient information.

Compensation:
Salary range is competitive and based on various factors including education, experience, and certifications.

In addition to salary, RMCC offers a comprehensive benefits package, which may include:

Health, dental, and vision insurance; wellness initiatives; health savings and flexible spending accounts; retirement plans; life insurance; short-term and long-term disability coverage; Employee Assistance Programs; paid time off; holiday pay; tuition reimbursement; and critical illness and accident insurance.


Qualifications:

MINIMUM REQUIREMENTS:
High school diploma or equivalent. A minimum of two (2) years of experience in medical insurance verification and authorization is required. Experience in billing and coding is preferred.


All candidates must successfully complete a background check and a non-federal drug test (excluding marijuana) following a job offer and prior to employment.


PHYSICAL REQUIREMENTS:

The physical demands outlined here are representative of those required to perform the essential functions of this position.

Reasonable accommodations may be made for individuals with disabilities to perform essential job functions.

While executing job responsibilities, employees are regularly required to sit and use their hands for tasks such as typing and handling documents.

Employees may occasionally need to stand, walk, and reach with their arms. The role may require lifting and/or moving items weighing up to 30 pounds. Vision and hearing must be corrected to normal ranges.

WORK ENVIRONMENT:

The characteristics of the work environment described here are typical for employees performing essential job functions.

Reasonable accommodations may be made for individuals with disabilities to perform essential job functions.

Work is primarily conducted in an office setting, involving frequent interactions with patients, clinical staff, and insurance representatives.


All candidates must successfully complete a background check and a non-federal drug test (excluding marijuana) following a job offer and prior to employment.

Applications are accepted on an ongoing basis for this position.

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